A spot, a mark or a wart on the penis or scrotum is a cause for worry and often for embarrassment, which delays the examination by months. Many of these growths are harmless, but some are contagious or need treatment, and to the naked eye they can look the same. Dermatoscopy is a quick and painless magnified examination with which Dr Penev tells them apart during the consultation itself.
When it is recommended
A dermatoscopic examination is done for:
- new warts, spots or small lumps on the penis, scrotum, groin or around the anus – to tell genital warts apart from other growths;
- tiny white spots along the rim of the glans or on the scrotum – most often pearly penile papules or sebaceous glands, which are a normal variant;
- redness, patches and cracked skin on the glans in balanitis or skin conditions such as lichen sclerosus;
- pigmented patches and moles in the genital area, especially if they change in size or colour;
- follow-up after genital wart treatment, to find any new lesions early;
- a sore or ulcer that has not healed within two or three weeks.
Two situations should not be put off: a foreskin that has been pulled back and cannot be returned over the glans, which swells and hurts (paraphimosis), and rapidly spreading redness and swelling of the genitals with a high temperature. In these cases go to an emergency department straight away or call 112 (the European emergency number) instead of waiting for a booked appointment.
What happens
The dermatoscope is a hand-held optical instrument with strong lighting and about tenfold magnification. Dr Penev holds it close to the skin, sometimes with a drop of gel, and examines the structure, colour and blood vessels of the growth – details that cannot be seen with the naked eye. Genital warts, for example, have an uneven surface with their own blood vessels, pearly papules are identical dome-shaped bumps in regular rows, and molluscum (molluscum contagiosum – small contagious viral spots) has a whitish centre.
The examination takes a few minutes, does not hurt and leaves no marks. If needed, the growths are photographed so that any change can be tracked. The examination can be done during the urology consultation – mention when you book that you are looking for a consultation about skin growths.
Preparation
No special preparation is needed – your usual hygiene is enough. On the day of the examination do not apply creams or powder to the area and do not try to remove the growths. Write down the products you have used, roughly when the changes appeared and whether your partner has similar symptoms.
Results – what it shows
In most cases Dr Penev can tell you during the examination whether it is genital warts, pearly papules, molluscum, sebaceous glands or inflammation, and can suggest treatment or reassure you that none is needed. Dermatoscopy, however, is an examination, not a laboratory test. When the appearance is unusual, the growth is pigmented, grows quickly, bleeds or does not respond to treatment, a small sample is taken for histology (examination under the microscope). With genital warts, tests for other sexually transmitted infections are also recommended, as they often occur together.
Where it is done
The dermatoscopic examination is done by appointment at Dr Penev’s urology practice in Plovdiv, 5 Anri Barbyus St. Patients from Karlovo can ask when booking whether the examination can be done at Vita Med Medical Centre, Karlovo.
Price
Initial consultation €50, follow-up consultation €30. Whether the dermatoscopic examination is included in the price of the consultation, and the price of any additional tests, is confirmed when you book.
A short visit is usually enough to get a clear answer and stop worrying. Book an appointment with Dr Penev – the examination is discreet, quick and painless.
Frequently asked questions
Should I avoid sex before the examination?
It is not necessary. However, if you have fresh injuries or have used creams or other products on the area in the last few days, tell Dr Penev – this changes how the skin looks and is taken into account during the examination.
Can dermatoscopy prove for certain that I have genital warts?
In most cases the typical appearance is enough for a diagnosis and to start treatment. If the appearance is unusual, another condition is suspected or treatment is not working, Dr Penev recommends a biopsy or further tests.
Does dermatoscopy replace an HPV test?
No. Dermatoscopy shows what the growth looks like, while the test detects whether the virus is present and which type it is. With typical genital warts, typing usually does not change the treatment and is arranged at the doctor's discretion.
Should my partner be examined too?
If genital warts or another sexually transmitted infection are found, it is advisable for your partner to be examined as well, even without symptoms, because some infections go unnoticed.
The information on this website is for general education and does not replace an examination and consultation with a doctor. If you have urgent symptoms, seek medical help immediately or call 112.